Wednesday, March 6, 2013

Pasteur, Lister, and Fleming

Patient Recognition Month Poster
I have been attempting to manage my family member’s post- operative care as best as I can. I must say that I have learned a lot, both from providing the nursing care, and from bothering my gracious surgeon friends. A serosanguinous discharge emerged from the abdominal wound after a week. It came from a local point around the umbilicus, and as the patient did not have fever, pain, or decreased appetite, I thought of it as a minor, temporary nuisance only. I then went on the Internet, after which I proceeded to freak out (now I know how my patients feel). Googling serosanguinous drainage and abdominal surgery, I came up with a lot of hits on wound dehiscence (when the wound opens up, the patient is at risk for sepsis, and re-operation is indicated). Oy. I was reassured (kind of) by the surgeon who performed the procedure that dehiscence was highly unlikely, that I should open up the wound with a q-tip gently to allow the fluid to flow more freely and that I should perhaps insert a large bore needle to aspirate the fluid.

I did not know that I was going to be a surgical intern, but here I am. I performed the q-tip maneuver but elected to not stick any sharp objects into the wound. I had my family member seen by a surgeon colleague of mine, who probed the wound to make sure that there was no dehiscence (there was not), and who then took out some staples and packed the open part of the wound with Iodoform gauze. With these maneuvers, and with some Penicillin, the wound has finally dried up. The bloody discharge was also freaking out the patient, making the patient more reluctant to get out of bed and move around. With the wound finally dry, the patient was confidant enough to get of the house for an enjoyable shopping excursion (thankfully without me- I have the typical guy response to shopping; i.e., I want to get out of there in about 5 minutes).

As the song goes, “don’t know much about surgery”, but I do know that Pasteur, Lister, and Fleming have made major surgeries possible by recognizing and fighting off bacteria from destroying the handiwork of the surgeon. I thank these giants of medicine, and my family member patient thanks them as well.

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